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| 1 | Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma.显示文摘 | Abrey LE Batchelor TT Ferreri A J Gospodarowicz M Pulczynski EJ Zucca E Smith JR Korfel A Soussain C DeAngelis LM Neuwelt EA O′Neill BP Thiel E Shenkier T Graus F van den Bent M Seymour JF Poortmans P Armitage JO Cavalli F | 2005 | 中国神经肿瘤杂志2005，3，3： | 53 |
| 2 | 美国国立老化研究所与阿尔茨海默病协会诊断指南写作组:阿尔茨海默病临床前阶段的定义显示文摘阿尔茨海默病(AD)的病理生理过程在痴呆诊断的多年前就开始了。这一长期的AD“临床前”阶段是治疗干预的关键机会,但需进一步阐明AD的病理级联过程和临床症状出现之间的联系。美国国立老化研究所和AD协会召集了一个国际工作组对AD生物标志物、流行病学和神经心理学的证据进行综述并提出建议,以确定能够预测由“正常”认知到轻度认知功能障碍(MCI)及AD痴呆的最佳预测指标。根据目前已有的主要科学证据,我们提出了一个概念性的框架和用于操作的研究标准,以通过纵向临床研究来验证和改进这些模型。这些建议仅用于研究目的,目前不涉及临床应用。我们希望这些建议能提供一个共识,以推进临床前AD的研究,最终推动更早期治疗干预的进展,使得一些疾病减缓药物的疗效发挥最大。 | Sperling RA Aisen PS Beckett LA Bennett DA Craft S Fagan AM Iwatsubo T Jack CR Jr Kaye J Montine TJ Park DC Reiman EM Rowe CC Siemers E Stern Y Yaffe K Carrillo MC Thies B Morrison-Bogorad M Wagster MV Phelps CH 贾建平(译) 郭起浩(译) 黄丽(译) 陆璐(译) 张逸驰(译) 邢怡(译) | 2012 | 中华神经科杂志2012，45，5： | 22 |
| 3 | Alcohol-induced steatosis in liver cells显示文摘Alcohol-induced fatty liver (steatosis) was believed to result from excessive generation of reducing equivalents from ethanol metabolism, thereby enhancing fat accumulation. Recent findings have revealed a more complex picture in which ethanol oxidation is still required, but specific transcription as well as humoral factors also have important roles. Transcription factors involved include the sterol regulatory element binding protein 1 (SREBP-1) which is activated to induce genes that regulate lipid biosynthesis. Conversely, ethanol consumption causes a general down-regulation of lipid (fatty acid) oxidation, a reflection of inactivation of the peroxisome proliferator- activated receptor-alpha (PPAR-α) that regulates genes involved in fatty acid oxidation. A third transcription factor is the early growth response-1 (Egr-1), which is strongly induced prior to the onset of steatosis. The activities of all these factors are governed by that of the principal regulatory enzyme, AMP kinase. Important humoral factors, including adiponectin, and tumor necrosis factor-α (TNF-α), also regulate alcohol-induced steatosis. Their levels are affected by alcohol consumption and by each other. This review will summarize the actions of these proteins in ethanol-elicited fatty liver. Because steatosis is now regarded as a significant risk factor for advanced liver pathology, an understanding of the molecular mechanisms in its etiology is essential for development of effective therapies. | Terrence M Donohue Jr | 2007 | World Journal of Gastroenterology2007，13，37： | 21 |
| 4 | Autophagy and ethanol-induced liver injury显示文摘The majority of ethanol metabolism occurs in the liver. Consequently, this organ sustains the greatest damage from ethanol abuse. Ethanol consumption disturbs the delicate balance of protein homeostasis in the liver, causing intracellular protein accumulation due to a disruption of hepatic protein catabolism. Evidence indicates that ethanol or its metabolism impairs trafficking events in the liver, including the process of macroautophagy, which is the engulfment and degradation of cytoplasmic constituents by the lysosomal system. Autophagy is an essential, ongoing cellular process that is highly regulated by nutrients, endocrine factors and signaling pathways. A great number of the genes and gene products that govern the autophagic response have been characterized and the major metabolic and signaling pathways that activate or suppress autophagy have been identified. This review describes the process of autophagy, its regulation and the possible mechanisms by which ethanol disrupts the process of autophagic degradation. The implications of autophagic suppression are discussed in relation to the pathogenesis of alcohol-induced liver injury. | Terrence M Donohue Jr | 2009 | World Journal of Gastroenterology2009，15，10： | 11 |
| 5 | Bacterial biota in reflux esophagitis and Barrett's esophagus显示文摘AIM: To identify the bacterial flora in conditions such as Barrett's esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.METHODS: Using broad-range 16S rDNA PCR,esophageal biopsies were examined from 24 patients [9with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett's esophagus].Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned.In one patient with Barrett's esophagus, g9 PCR clones were analyzed.RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria,5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett's esophagus patients, and 10 in normal esophagus patients.Further analysis concentrating on a single biopsy from an individual with Barrett's esophagus revealed the presence of 21. distinct bacterial species. Members of four phyla were represented, including Bacteroidetes,Firmicutes, Proteobacteria, and Actinobacteria.Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations. | Zhiheng Pei Liying Yang Richard M Peek Jr Steven M Levine David T Pride Martin J Blaser | 2005 | World Journal of Gastroenterology2005，11，46： | 11 |
| 6 | Implication of altered proteasome function in alcoholic liverinjury显示文摘The proteasome is a major protein-degrading enzyme, which catalyzes degradation of oxidized and aged proteins, signal transduction factors and cleaves peptides for antigen presentation. Proteasome exists in the equilibrium of 26S and 20S particles. Proteasome function is altered by ethanol metabolism, depending on oxidative stress levels: low oxidative stress induces proteasome activity, while high oxidative stress reduces it. The proposed mechanisms for modulation of proteasome activity are related to oxidative modification of proteasomal proteins with primary and secondary products derived from ethanol oxidation. Decreased proteolysis by the proteasome results in the accumulation of insoluble protein aggregates, which cannot be degraded by proteasome and which further inhibit proteasome function. Mallory bodies, a common signature of alcoholic liver diseases, are formed by liver cells, when proteasome is unable to remove cytokeratins. Proteasome inhibition by ethanol also promotes the accumulation of pro-apoptotic factors in mitochondria of ethanol-metabolizing liver cells that are normally degraded by proteasome. In addition, decreased proteasome function also induces accumulation of the negative regulators of cytokine signaling (I-kB and SOCS), thereby blocking cytokine signal transduction. Finally, ethanol-elicited blockade of interferon type 1 and 2 signaling and decreased proteasome function impairs generation of peptides for MHC class Ⅰ-restricted antigen presentation. | Natalia A Osna Terrence M Donohue Jr | 2007 | World Journal of Gastroenterology2007，13，37： | 10 |
| 7 | Mycophenolate mofetil for drug-induced vanishing bile duct syndrome显示文摘Amoxicillin/clavulanate is associated with liver injury, mostly of a cholestatic pattern. While outcomes are usually benign, progression to cirrhosis and death has been reported. The role of immunosuppressive therapy for patients with a protracted course is unclear. We report the case of an elderly patient who developed prolonged cholestasis secondary to amoxicillin/clavulanate. Vanishing bile duct syndrome was confirmed by sequential liver biopsies. The patient responded to prednisone treatment, but could not be weaned off corticosteroids, even when azathioprine was added. Complete withdrawal of both prednisone and azathioprine was possible by using mycophenolate mofetil, an inosine monophosphate dehydrogenase inhibitor. Sustained remission has been maintained for more than 3 years with low-dose mycophenolate mofetil. | S Simona Jakab A Brian West Dennis M Meighan Robert S Brown Jr William B Hale | 2007 | World Journal of Gastroenterology2007，13，45： | 8 |
| 8 | 急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议(英文)显示文摘The objective of this guideline is to outline the role of magnetic resonance imaging(MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury(SCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI.This review focused on longitudinal studies that controlled for baseline neurologic status.A multidisciplinary Guideline Development Group(GDG) used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for SCI patients.Based on GRADE(Grading of Recommendation,Assessment,Development and Evaluation),a strong recommendation is worded as ' we recommend,' whereas a weaker recommendation is indicated by 'we suggest.' Results Based on the limited available evidence and the clinical expertise of the GDG,our recommendations were:(1) 'We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention,when feasible,to facilitate improved clinical decision-making'(quality of evidence,very low) and(2) 'We suggest that MRI should be performed in adult patients in the acute period following SCI,before or after surgical intervention,to improve prediction of neurologic outcome '(quality of evidence,low).Conclusions These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI. | Fehlings MG Martin AR Tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns AS Chiba K Dettori JR Furlan JC Hawryluk G Holly LT Howley S Jeji T Kalsi-Ryan S Kotter M Kurpad S Kwon BK Marino RJ Massicotte E Merli G Middleton JW Nakashima H Nagoshi N Palmieri K Singh A Skelly AC Tsai EC Vaccaro A Wilson JR Yee A Harrop JS | 2017 | 中华神经外科疾病研究杂志2017，16，6： | 8 |
| 9 | 诊断性试验和策略的证据质量和推荐强度的分级显示文摘GRADE系统能对诊断性试验或策略的证据质量和推荐强度进行分级。本文旨在阐释在此过程中如何考虑患者的重要结局, | Holger J Schünemann Andrew D Oxman Jan Brozek Paul Glasziou Roman Jaeschke Gunn E Vist John W Williams Jr Regina Kunz Jonathan Craig Victor M Montori Patrick Bossuyt Gordon H Guyatt 李晓 黄程 陈耀龙 李幼平 | 2009 | 中国循证医学杂志2009，9，5： | 7 |
| 10 | Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions显示文摘During the last 15 years we have witnessed an unprecedented expansion in the drugs developed to target human epidermal growth factor receptor-2(HER-2) positive breast cancer. Trastuzumab, pertuzumab, adotrastuzumab emtansine and lapatinib are currently food and drug administration(FDA)-approved for the treatment of breast cancer patients with HER-2 overexpressed. However, given the amount of information gathered from years of uninterrupted clinical research, it is essential to have periodic updates that succinctly recapitulate what we have learnt over these last years and help us to apply that information in our daily practice. This review will pursue that objective. We will summarize the most relevant and updated informationrelated to the state of the art management of HER-2 positive breast cancer in all the clinical scenarios including the adjuvant, neoadjuvant and metastatic settings. But we will also critically appraise that literature in order to highlight some key clinical concepts that should not be overlooked. Lastly, this review will also point out some of the most promising strategies that are currently being tested and may soon become available. | Gonzalo Recondo Jr Enrique Dìaz Canton Màximo de la Vega Martin Greco Gonzalo Recondo Sr Matias E Valsecchi | 2014 | World Journal of Clinical Oncology2014，5，3： | 7 |
| 11 | 非诺贝特治疗与2型糖尿病患者长期心血管病风险的关系显示文摘2型糖尿病患者心血管病风险高,部分原因在于高三酰甘油和低高密度脂蛋白胆固醇血症。而在他汀类药物治疗基础上,加强降低三酰甘油治疗,能否降低这种风险尚不清楚。该研究的目的是在使用他汀类药物治疗的2型糖尿病患者中,确定非诺贝特能否降低心血管病风险。 | 刘莉 叶鹏 Elam MB Ginsberg HN Lovato LC Corson M Largay J Leiter LA Lopez C O'Connor PJ Sweeney ME Weiss D Friedewald WT Buse JB Gerstein HC Probstfield J Grimm R Ismail-Beigi F Goff DC Jr Fleg JL Rosenberg Y Byington RP ACCORDION study investigators | 2017 | 中华高血压杂志2017，25，6： | 7 |
| 12 | Tooth-derived stem cells: Update and perspectives显示文摘Tissue engineering is an emerging field of science that focuses on creating suitable conditions for the regeneration of tissues. The basic components for tissue engineering involve an interactive triad of scaffolds, signaling molecules, and cells. In this context,stem cells(SCs) present the characteristics of selfrenewal and differentiation capacity, which make them promising candidates for tissue engineering. Although they present some common markers, such as cluster of differentiation(CD)105, CD146 and STRO-1, SCs derived from various tissues have different patterns in relation to proliferation, clonogenicity, and differentiation abilities in vitro and in vivo. Tooth-derived tissues have been proposed as an accessible source to obtain SCs with limited morbidity, and various tooth-derived SCs(TDSCs) have been isolated and characterized, such as dental pulp SCs, SCs from human exfoliated deciduous teeth, periodontal ligament SCs, dental follicle progenitor cells, SCs from apical papilla, and periodontal ligament of deciduous teeth SCs. However, heterogeneity among these populations has been observed, and the best method to select the most appropriate TDSCs for regeneration approaches has not yet been established. The objective of this review is to outline the current knowledge concerning the various types of TDSCs, and discuss the perspectives for their use in regenerative approaches. | Miki Taketomi Saito Karina Gonzales Silvério Márcio Zaffalon Casati Enilson Antonio Sallum Francisco Humberto Nociti Jr | 2015 | World Journal of Stem Cells2015，7，2： | 6 |
| 13 | Percutaneous closure of secundum type atrial septal defects:More than 5-year follow-up显示文摘AIM: To investigate long-term efficacy of two different devices more than five years after percutaneous atrial septal defect(ASD) closure in adults.METHODS: All patients who underwent percutaneous closure of an ASD in the St. Antonius Hospital, Nieuwegein, The Netherlands, between February 1998 and December 2006 were included. Percutaneous closure took place under general anaesthesia and transesophageal echocardiographic moni toring. Transthoracic echocardiography(TTE) was performed 24 h post-procedure to visualize the device position and to look for residual shunting using color Doppler. All complications were registered. All patients were invited for an outpatient visit and contrast TTE more than 5-years after closure. Efficacy was based on the presence of a residual right-to-left shunt(RLS), graded as minimal, moderate or severe. The presence of a residual left-to-right shunt(LRS) was diagnosed using color Doppler, and was not graded. Descriptive statistics were used for patients' characteristics. Univariate analysis was used to identify predictors for residual shunting.RESULTS: In total, 104 patients(mean age 45.5 ± 17.1 years) underwent percutaneous ASD closure using an Amplatzer device(ASO) in 76 patients and a Cardioseal/Starflex device(CS/SF) in 28 patients. The mean follow-up was 6.4 ± 3.4 years. Device migration occurred in 4 patients of whom two cases occurred during the index hospitalization(1 ASO, 1 CS/SF). The other 2 cases of device migration occurred during the first 6 mo of follow-up(2 CS/SF). The recurrent thrombo-embolic event rate was similar in both groups: 0.4% per follow-up year. More than 12 mo post-ASD closure and latest follow-up, new-onset supraventricular tachyarrhythmia's occurred in 3.9% and 0% for the ASO and CS/SF group, respectively. The RLS rate at latest follow-up was 17.4%(minimal 10.9%, moderate 2.2%, severe 4.3%) and 45.5%(minimal 27.3%, moderate 18.2%, severe 0%) for the ASO- and CS/SF groups, respectively. There was no residual LRS in both groups.CONCLUSION: Percutaneous ASD closure has good long-term safety and efficacy profiles. The residual RLS rate seems to be high more than 5 years after closure, especially in the CS/SF. Residual LRS was not observed. | Roel JR Snijder Maarten J Suttorp Jurrien M Ten Berg Martijn C Post | 2015 | World Journal of Cardiology2015，7，3： | 6 |
| 14 | Soil boron fertilization:The role of nutrient sources and rootstocks in citrus production显示文摘Boron(B) is a key element for citrus production, especially in tropical regions, where the nutrient availability is commonly low in the soil. In addition, information about doses, fertilizer sources, methods of application, and particularly, differential nutrient demand of scion/rootstock combinations are required for efficient fertilization of commercial groves. In a non-irrigated sweet orange orchard(cv. Natal), grafted onto Rangpur lime, Swingle citrumelo or Sunki mandarin, we studied the application of two sources of B: boric acid(17% B, soluble in water) and ulexite(12% B, partially soluble in water) at four levels of supply(control without B, and soil application of 2, 4 and 6 kg ha^(-1) yr^(-1) of B). The experiment was carried out for three years(2004-2006). Boron availability in the soil and concentration in the leaves, as well as the fruit yield and quality of trees were evaluated. Soil B extracted with hot water and total leaf B positively correlated with doses of the nutrient applied to the trees. Levels of B in the soil and in the leaves did not vary with fertilizer sources. Fruit yield of trees grafted onto Rangpur lime and Swingle citrumelo was more responsive to B doses than those grafted onto Sunki mandarin. The maximum fruit yield of trees grafted onto Swingle was obtained with 3.2 kg ha^(-1) yr^(-1) of B, and leaf B level of 280 mg kg^(-1) that point out to a highest demand for B when this combination was compared with other rootstocks. Furthermore, fertilization with B did not affect the quality of fruits, but correlated with B and potassium(K) concentrations in the leaves. These results also support that the current recommendations for levels of B in leaves should be revisited. | Dirceu Mattos Jr Franz W R Hippler Rodrigo M Boaretto Eduardo S Stuchi Jose A Quaggio | 2017 | Journal of Integrative Agriculture2017，16，7： | 5 |
| 15 | CTGF, intestinal stellate cells and carcinoid fi brogenesis显示文摘AIM: To investigate the role of small intestinal carcinoid tumor-derived fibrotic mediators, TGFβ1 and CTGF, in the mediation of fi brosis via activation of an 'intestinal' stellate cell. METHODS: GI carcinoid tumors were collected for Q RT-PCR analysis of CTGF and TGFβ1. Markers of stellate cell desmoplasia were identified in peritoneal fibrosis by immunohistochemistry and stellate cells cultured from fresh resected fibrotic tissue. CTGF and TGFβ1 were evaluated using quantitative tissue array profi ling (AQUA analysis) in a GI carcinoid tissue microarray (TMA) with immunostaining and correlated with clinical and histologically documented fi brosis. Serum CTGF was analyzed using a sandwich ELISA assay. RESULTS: Message levels of both CTGF and TGFβ1 in SI carcinoid tumors were signifi cantly increased (> 2-fold, P < 0.05) versus normal mucosa and gastric (non-f ibrotic) carcinoids. Activated stellate cells and markers of stellate cell-mediated fi brosis (vimentin, desmin) were identifi ed in histological fibrosis. An intestinal stellate cell was immunocytochemically and biochemically characterized and its TGFβ1 (10-7M) initiated CTGF transcription response (> 3-fold, P < 0.05) demonstrated. In SI carcinoid tumor patients with documented fi brosis, TMA analysis demonstrated higher CTGF immunostaining (AQUA Score: 92 ± 8; P <0.05), as well as elevated TGFβ1 (90.6 ± 4.4, P < 0.05). Plasma CTGF (normal 12.5 ± 2.6 ng/mL) was increased in SI carcinoid tumor patients (31 ± 10 ng/mL, P < 0.05) compared to non-fi brotic GI carcinoids (< 15 ng/mL).CONCLUSION: SI carcinoid tumor fibrosis is a CTGF/ TGFβ1-mediated stellate cell-driven fibrotic response. The delineation of the biology of fibrosis will facilitate diagnosis and enable development of agents to obviate its local and systemic complications. | M Kidd IM Modlin MD Shapiro RL Camp SM Mane W Usinger JR Murren | 2007 | World Journal of Gastroenterology2007，13，39： | 5 |
| 16 | 奶牛业中霉菌和霉菌毒素的问题(一)显示文摘霉菌毒素是由真菌(霉菌)产生的毒性次级代谢产物,当动物采食了被污染的饲料,或者接触或吸人霉菌时,可引起不良影响(霉菌中毒),其生物学影响包括肝和肾的中毒、中枢神经系统与雌激素的影响等。只有部分霉菌产生霉菌毒素,称为产毒霉菌。霉菌毒素的化学变化多,这也代表化学家族的多样性——分子量范围约200~500。 | 王银东 L W Whitlow W M Hagler Jr | 2010 | 中国畜牧杂志2010，46，2： | 5 |
| 17 | AIDS-associated plasmablastic lymphoma presenting as a poorly differentiated esophageal tumor: A diagnostic dilemma显示文摘Plasmablastic lymphoma (PBL) is a rare form of diffuse large B-cell lymphoma characterized by weak/absent expression of conventional B-cell markers and strong expression of plasma cell markers. It is strongly associated with human immunodeficiency virus (HIV) and Epstein Barr virus infection, and shows an unusual tropism to the oral cavity. Herein we describe a patient with AIDS who presented with weight loss and dysphagia owing to a large gastroesophageal mass. His radiographic and endoscopic findings and long history of cigarette consumption suggested carcinoma. Biopsy demonstrated a poorly differentiated tumor stained negatively to routine lymphoid markers including CD20. However, gene rearrangement studies confirmed a B-cell process and a more detailed immunohistochemical analysis revealed the cells stained positively for CD138 (plasma cell antigen). These findings were diagnostic of PBL. Our report reviews the wide differential diagnosis of PBL and underscores the importance of a broad array of viral and molecular studies needed to establish this diagnosis. | Deepthi Mani Donald G Guinee Jr David M Aboulafia | 2008 | World Journal of Gastroenterology2008，14，27： | 4 |
| 18 | β-defensins and the epididymis: contrasting influences of prenatal, postnatal, and adult scenarios显示文摘β -defensins 是主人防卫的部件,与抗菌剂和多种的免疫调节的性质。在最后 15 年的研究表明了许多 β 的丰富的表示;在不同种类的出生后的 epididymis 的 -defensins。这些蛋白质的区域特定、房间特定的表示的一个坡度在出生后的 epididymis 的上皮被观察。他们进到他们沿着 epididymis 旅行的精子的钠液体和绑定的分泌物在繁殖特定的任务建议了他们的参与。因此,连续注意被给了各种各样的 β为他们在精子功能和富饶的角色的 -defensins。尽管 β -defensins 大部分依赖于雄激素,在 epididymis 调整他们的表达式和函数的内在的机制很好没被理解。最近的调查指出了到在哪儿的一种新、有趣的情形 β ; -defensins 在 Wolffian 管与一个不同表示模式出现, epididymis 的胚胎的先锋与成年 epididymis 对比,从而有关 β 的多功能的角色重新定义这个概念;在发展中的 epididymis 的 -defensins 。在这评论,我们总结 β 的一些当前的看法;在在 prenatal-to-postnatal 转变期间在发展中的 epididymis 在他们的角色上加亮我们的最近的数据和推测的 epididymis 的 -defensins ,在可以贡献 epididymal 生物学和男富饶的更好的理解的这个研究区域把注意带到许多未答复的问题。 | Camilla M Ribeiro Erick JR Silva Barry T Hinton Maria Christina W Avellar | 2016 | Asian Journal of Andrology2016，18，2： | 4 |
| 19 | 奥马达环素治疗社区获得性细菌性肺炎显示文摘背景及目的澳马达环素(omadacycline)是一种可每日1次静脉或口服给药的新型氨甲基环素类抗生素,在肺组织内的浓度较高,对引起社区获得性细菌性肺炎(CAP)的常见病原体有抗菌活性。 | Stets R Popescu M Gonong JR 牟向东 郭军 | 2019 | 中华结核和呼吸杂志2019，42，12： | 3 |
| 20 | Intraductal papillary mucinous neoplasm and the pancreatic incidentaloma显示文摘Asymptomatic pancreatic lesions(APL) are a commonly encountered problem in today's pancreatic surgical practices.Current literature regarding etiologies and incidence of APLs,particularly intraductal papillary mucinous neoplasm(IPMN),is presented.APLs constitute a wide spectrum of pathology(solid/cystic,benign/premalignant/malignant) but,overall,IPMN is now the most common diagnosis.The Sendai Guidelines and their function as a basis for risk stratification in branch duct IPMN are presented.The importance of traditionally analyzed cyst characteristics including size,presence of mucin or nodules and cyst fluid aspirate as indicators of malignancy is emphasized,noting also the potential correlation of main duct dilatation,thickened septae and elevated cyst fluid CEA with increased risk of malignancy.Current complication rates after resection of APLs are reviewed and found to be generally equivalent to those for symptomatic resections.A potential multidisciplinary treatment strategy is offered considering the costs of surgery versus repeated imaging or follow up endoscopy for these lesions.The decision for intervention is ultimately based on the Sendai Guidelines in the context of the individual patient. | Tara S Kent Charles M Vollmer Jr Mark P Callery | 2010 | World Journal of Gastrointestinal Surgery2010，2，10： | 3 |
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